Introduction: Research on the impact of physical activity (PA) and physical fitness on oral health has been limited in scope. The aim of this report was to assess the impact of PA and physical fitness as modifiable factors in dental caries and erosive tooth wear (ETW) among middle-aged individuals in Finland. Methods: Data were gathered from the North Finland Birth Cohort 1966 (NFBC1966) 46-year follow-up, which included dental clinical examinations conducted by seven calibrated dentists, physical fitness tests, measurements of PA, and measurements of height and weight administered between 2012 and 2014. PA was measured over a 2-week period with a wrist-worn accelerometer and reported as average daily duration of PA (min/day). Physical fitness was assessed by measuring cardiorespiratory fitness via heart rate recovery in a step test using a heart rate monitor and chest belt, and by evaluating back strength with the Biering-Sorensen test. Of the whole cohort, 1,964 cohort members participated in the oral clinical examination, and the regression models were conducted with 1,590 participants. The prevalence of dental caries (ICDAS), DMFT score, and ETW (BEWE), and the results of the PA test and physical fitness tests were categorized and analyzed using cross-tabulations and multivariable logistic regression models. SPSS version 29.0.0.0 was used to calculate 95% confidence intervals (CI), odds ratios (ORs), χ2, and p values. Results: Poor (OR 1.60, 95% CI: 1.15–2.23) and moderate (OR 1.48, 95% CI: 1.14–1.93) cardiorespiratory fitness and low PA (OR 1.48, 95% CI: 1.07–2.05) were associated with dentine caries in the regression model. The same model indicated that tooth brushing frequency (OR 1.97, 95% CI: 1.21–3.20), ETW (OR 1.30, 95% CI: 1.12–1.49), and male gender (OR 1.22, 95% CI: 1.05–1.43) were associated with increased dentine caries. No statistically significant association was found between PA or physical fitness and ETW. Conclusion: In the middle-aged Finnish population, high PA and good physical fitness are associated with a lower prevalence of dentine caries. No association between PA or physical fitness and ETW was found. Further research is needed to explore the potential oral health benefits of PA and physical fitness as modifiable factors.

1.
Laajala
A
,
Karhatsu
P
,
Pesonen
P
,
Laitala
ML
,
Näpänkangas
R
,
Raustia
A
, et al
.
Association of indirect restorations with past caries history and present need for restorative treatment in the Northern Finland Birth Cohort 1966
.
Clin Oral Investig
.
2018
;
22
(
3
):
1495
501
.
2.
National Institute of dental and craniofacial research (NIDCR)
[Internet]. Tooth Decay [cited 2024 Apr 21]. Available from: https://www.nidcr.nih.gov/health-info/tooth-decay
3.
Alaraudanjoki
V
,
Laitala
ML
,
Tjäderhane
L
,
Pesonen
P
,
Lussi
A
,
Anttonen
V
.
Association of erosive tooth wear and dental caries in Northern Finland Birth Cohort 1966 - an epidemiological cross-sectional study
.
BMC Oral Health
.
2016
;
17
(
1
):
6
.
4.
Carvalho
TS
,
Colon
P
,
Ganss
C
,
Huysmans
MC
,
Lussi
A
,
Schlueter
N
, et al
.
Consensus report of the European federation of conservative dentistry: erosive tooth wear diagnosis and management
.
Swiss Dent J
.
2016
;
126
(
4
):
342
6
.
5.
Warburton
DE
,
Nicol
CW
,
Bredin
SS
.
Health benefits of physical activity: the evidence
.
CMAJ
.
2006
;
174
(
6
):
801
9
.
6.
Ashley
P
,
Di Iorio
A
,
Cole
E
,
Tanday
A
,
Needleman
I
.
Oral health of elite athletes and association with performance: a systematic review
.
Br J Sports Med
.
2015
;
49
(
1
):
14
9
.
7.
Needleman
I
,
Ashley
P
,
Fine
P
,
Haddad
F
,
Loosemore
M
,
de Medici
A
, et al
.
Oral health and elite sport performance
.
Br J Sports Med
.
2015
;
49
(
1
):
3
6
.
8.
Frese
C
,
Frese
F
,
Kuhlmann
S
,
Saure
D
,
Reljic
D
,
Staehle
HJ
, et al
.
Effect of endurance training on dental erosion, caries, and saliva
.
Scand J Med Sci Sports
.
2015
;
25
(
3
):
e319
26
.
9.
Khan
K
,
Qadir
A
,
Trakman
G
,
Aziz
T
,
Khattak
MI
,
Nabi
G
, et al
.
Sports and energy drink consumption, oral health problems and performance impact among elite athletes
.
J Nutr
.
2022
;
14
(
23
):
5089
.
10.
Huttunen
M
,
Kämppi
A
,
Soudunsaari
A
,
Päkkilä
J
,
Tjäderhane
L
,
Laitala
ML
, et al
.
The association between dental caries and physical activity, physical fitness, and background factors among Finnish male conscripts
.
Odontology
.
2023
;
111
(
1
):
192
200
.
11.
Popa
,
Onișor
D
,
Nechita
A
,
Earar
K
,
Matei
MN
.
Study on the influence of regular physical activity on children’s oral health
.
Children
.
2023
;
10
(
6
):
946
.
12.
Bramantoro
T
,
Hariyani
N
,
Setyowati
D
,
Purwanto
B
,
Zulfiana
AA
,
Irmalia
WR
.
The impact of oral health on physical fitness: a systematic review
.
Heliyon
.
2020
;
6
(
4
):
e03774
.
13.
Nijakowski
K
,
Zdrojewski
J
,
Nowak
M
,
Podgórski
F
,
Surdacka
A
.
Regular physical activity and dental erosion: a systematic review
.
Appl Sci
.
2022
;
12
(
3
):
1099
.
14.
Tripodi
D
,
Cosi
A
,
Fulco
D
,
D’Ercole
S
.
The impact of sport training on oral health in athletes
.
Dent J
.
2021
;
9
(
5
):
51
.
15.
Drummond
LR
,
Campos
HO
,
Drummond
FR
,
de Oliveira
GM
,
Fernandes
JGRP
,
Amorim
RP
, et al
.
Acute and chronic effects of physical exercise on IgA and IgG levels and susceptibility to upper respiratory tract infections: a systematic review and meta-analysis
.
Pflugers Arch
.
2022
;
474
(
12
):
1221
48
.
16.
Ligtenberg
AJ
,
Brand
HS
,
van den Keijbus
PA
,
Veerman
EC
.
The effect of physical exercise on salivary secretion of MUC5B, amylase and lysozyme
.
Arch Oral Biol
.
2015
;
60
(
11
):
1639
44
.
17.
Nieman
DC
,
Wentz
LM
.
The compelling link between physical activity and the body's defense system
.
J Sport Health Sci
.
2019
;
8
(
3
):
201
17
.
18.
Akimoto
T
,
Kumai
Y
,
Akama
T
,
Hayashi
E
,
Murakami
H
,
Soma
R
, et al
.
Effects of 12 months of exercise training on salivary secretory IgA levels in elderly subjects
.
Br J Sports Med
.
2003
;
37
(
1
):
76
9
.
19.
Virtanen
JI
,
Muikku
T
,
Similä
T
,
Cinar
AB
,
Pohjola
V
.
Physical activity, BMI and oral health behaviour among adolescents: Finnish School Health Promotion Study
.
Eur J Public Health
.
2019
;
29
(
2
):
296
302
.
20.
University of Oulu [Internet]
.
Northern Finland Birth cohorts and arctic biobank
. [cited 2024 Apr 21]. Available from: http://www.oulu.fi/nfbc/
21.
Nordström
T
,
Miettunen
J
,
Auvinen
J
,
Ala-Mursula
L
,
Keinänen-Kiukaanniemi
S
,
Veijola
J
, et al
.
Cohort profile: 46 years of follow-up of the northern Finland Birth cohort 1966 (NFBC1966)
.
Int J Epidemiol
.
2022
;
50
(
6
):
1786
7j
.
22.
Ismail
AI
,
Sohn
W
,
Tellez
M
,
Amaya
A
,
Sen
A
,
Hasson
H
, et al
.
The International Caries Detection and Assessment System (ICDAS): an integrated system for measuring dental caries
.
Community Dent Oral Epidemiol
.
2007
;
35
(
3
):
170
8
.
23.
Bartlett
D
,
Ganss
C
,
Lussi
A
.
Basic Erosive Wear Examination (BEWE): a new scoring system for scientific and clinical needs
.
Clin Oral Investig
.
2008
;
12
(
Suppl 1
):
S65
8
.
24.
Shaw
J
,
Jacobs
JV
,
Van Dillen
LR
,
Beneck
GJ
,
Smith
JA
.
Understanding the Biering-Sørensen test: contributors to extensor endurance in young adults with and without a history of low back pain
.
J Electromyogr Kinesiol
.
2024
;
74
:
102854
.
25.
Niemelä
MS
,
Kangas
M
,
Ahola
RJ
,
Auvinen
JP
,
Leinonen
AM
,
Tammelin
TH
, et al
.
Dose-response relation of self-reported and accelerometer-measured physical activity to perceived health in middle age-the Northern Finland Birth Cohort 1966 Study
.
BMC Public Health
.
2019
;
19
(
1
):
21
.
26.
Jetté
M
,
Sidney
K
,
Blümchen
G
.
Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity
.
Clin Cardiol
.
1990
;
13
(
8
):
555
65
.
27.
Leinonen
AM
,
Ahola
R
,
Kulmala
J
,
Hakonen
H
,
Vähä-Ypyä
H
,
Herzig
KH
, et al
.
Measuring physical activity in free-living conditions-comparison of three accelerometry-based methods
.
Front Physiol
.
2016
;
7
:
681
.
28.
Pelttari
H
.
Painoindeksi (BMI) [internet]. Lääkärikirja duodecim. Helsinki: kustannus Oy duodecim
.
2024
. [cited 2024 Aug 17]. Available from: https://www.terveyskirjasto.fi/dlk01001
29.
Gallagher
J
,
Ashley
P
,
Petrie
A
,
Needleman
I
.
Oral health-related behaviours reported by elite and professional athletes
.
Br Dent J
.
2019
;
227
(
4
):
276
80
.
30.
Ntovas
P
,
Loumprinis
N
,
Maniatakos
P
,
Margaritidi
L
,
Rahiotis
C
.
The effects of physical exercise on saliva composition: a Comprehensive Review
.
Dent J
.
2022
;
10
(
1
):
7
.
31.
Suominen
AL
,
Varsio
S
,
Helminen
S
,
Nordblad
A
,
Lahti
S
,
Knuuttila
M
.
Dental and periodontal health in Finnish adults in 2000 and 2011
.
Acta Odontol Scand
.
2018
;
76
(
5
):
305
13
.
32.
Lipsky
MS
,
Su
S
,
Crespo
CJ
,
Hung
M
.
Men and oral health: a review of sex and gender differences
.
Am J Mens Health
.
2021
;
15
(
3
):
15579883211016361
.
33.
Kinnunen
H
,
Tanskanen
M
,
Kyröläinen
H
,
Westerterp
KR
.
Wrist-worn accelerometers in assessment of energy expenditure during intensive training
.
Physiol Meas
.
2012
;
33
(
11
):
1841
54
.
34.
Kinnunen
H
,
Häkkinen
K
,
Schumann
M
,
Karavirta
L
,
Westerterp
KR
,
Kyröläinen
H
.
Training-induced changes in daily energy expenditure: methodological evaluation using wrist-worn accelerometer, heart rate monitor, and doubly labeled water technique
.
PLoS One
.
2019
;
14
(
7
):
e0219563
.
35.
Römer
C
,
Wolfarth
B
.
Heart Rate Recovery (HRR) is not a singular predictor for physical fitness
.
Int J Environ Res Public Health
.
2022
;
20
(
1
):
792
.
36.
Huikari
S
,
Junttila
H
,
Ala-Mursula
L
,
Jämsä
T
,
Korpelainen
R
,
Miettunen
J
, et al
.
Leisure-time physical activity is associated with socio-economic status beyond income: cross-sectional survey of the Northern Finland Birth Cohort 1966 study
.
Econ Hum Biol
.
2021
;
41
:
100969
.
37.
Niemelä
M
,
Kiviniemi
A
,
Kangas
M
,
Farrahi
V
,
Leinonen
AM
,
Ahola
R
, et al
.
Prolonged bouts of sedentary time and cardiac autonomic function in midlife
.
Transl Sports Med
.
2019
;
2
(
6
):
341
50
.
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